Individual provider Active NPI

Kelli McLaughlin

  • Adult Health Nurse Practitioner
  • Prescott, AZ
National Provider Identifier
1750836086
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP8972 Issued in AZ
Practice address
1001 Willow Creek Rd Ste 3100
Prescott, AZ 86301-1614
Phone
(928) 445-4818
Fax
(928) 445-4837
NPI assigned
Aug 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP 9319660 FL
Adult Health Nurse Practitioner 363LA2200X AP8972 AZ Primary

Addresses

Primary practice location

1001 Willow Creek Rd Ste 3100
Prescott, AZ 86301-1614

Mailing address

PO Box 10880
Prescott, AZ 86304-0880
Phone (602) 406-4786

Other identifiers 1

IdentifierTypeStateIssuer
393303MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AZ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170623001031 FL Practitioner - Nurse Practitioner 2365710969 Reassigns benefits to 1 organization
I20180724001116 AZ Practitioner - Nurse Practitioner 2365710969 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Yavapai Regional Medical Center Physician Care LLCGroup PAC ID 5294898987, 123 clinicians

Practice addresses (Care Compare)

1001 Division St
Prescott, AZ 86301-1601
Phone (928) 445-4818

Hospital & facility affiliations

  • Yavapai Regional Medical Center Hospital, Prescott, AZ, CCN 030012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP 9319660FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
FM Medical Urgent Care, Inc. CurrentSince Jul 17, 2022 Accepting new patients
FM Medical Inc CurrentSince Mar 25, 2017 Accepting new patients
Yavapai Regional Medical Center Physician Care LLC CurrentSince Aug 26, 2018 Accepting new patients
Yavapai Regional Medical Center Physician Care LLC Current Accepting new patients
Prescott Gastroenterology Past Accepting new patients

Locations

1001 Willow Creek Rd
Ste 3100
Prescott, AZ 86301
Phone (928) 445-4818

1001 Division St
Prescott, AZ 86301
Phone (928) 445-4818

3120 Clearwater Dr
Prescott, AZ 86305
Phone (928) 445-4818

165 Southpark Blvd
Ste D
St Augustine, FL 32086
Phone (904) 823-8833

165 Southpark Blvd
St Augustine, FL 32086
Phone (904) 824-7597

3560 A1A S
St Augustine Beach, FL 32080
Phone (904) 584-2273

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1471305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1750836086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10880",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863040880",
            "telephone_number": "602-406-4786",
            "fax_number": "916-636-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 WILLOW CREEK RD STE 3100",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011614",
            "telephone_number": "928-445-4818",
            "fax_number": "928-445-4837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLAUGHLIN",
        "first_name": "KELLI",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-16",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP 9319660",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP8972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "393303",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.